When it Comes to Mortality and Health Insurance Rates, A Racial and Ethnic Divide Remains Prominent in Dallas County

In Dallas County, racial and ethnic disparities remain prominent in areas like maternal mortality and the ability to withstand chronic diseases, even as the disparities among those without health insurance have tightened in recent years.

Those are a few takeaways from the Dallas Economic Opportunity Assessment, a new report commissioned by the Communities Foundation of Texas (CFT) and conducted by the Austin-based Center for Public Policy Priorities (CPPP). The groups convened Tuesday morning at CFT to go through the findings at an event featuring comments by Dallas Mayor Mike Rawlings and Dallas County Judge Clay Jenkins.

The day revolved around examining areas for improvement, many of which center on disparities in opportunity by ZIP code, race, and ethnicity. “Today, we’re going to focus on the glass half-empty,” Rawlings said during his remarks.

The relatively good news first: There were 321,800 more Dallas County residents with health insurance in 2015, the latest year studied, than there were six years prior. Gaps in coverage remain but have tightened. About half of all Hispanics in the county were uninsured in 2009, compared to one in three in 2015.

The 332,000 uninsured Hispanics account for about 63 percent of all uninsured residents in Dallas County.

In 2015, 16.6 percent of blacks were uninsured (compared to 24.2 percent in 2009) and 9.4 percent of whites were uninsured (compared to 13.5 percent in ’09).

Dr. Frances Deviney, the chief operating officer at the CPPP who oversaw the study, attributed the improvements to the Affordable Care Act, which subsidized health insurance for the poor, and to the public health exchanges instituted in 2014. She said that investment in education about how to sign up, which has dropped off under the new administration, made a significant difference.

“I hope we don’t see a reverse. I hope we see a continuing leveling off,” Deviney said. “We’ve shown we can actually make improvement, and there’s no reason we should be making choices that don’t continue the good movement we’ve been making the last several years.”

When it comes to maternal mortality, the report found that, in 2014, 71.7 black mothers per 100,000 died during pregnancy, childbirth, or in the months after delivery—versus 26.2 Hispanic mothers and 22.5 white mothers.

Texas’ high maternal mortality rates have garnered significant attention this year after researchers at first showed the rate had doubled in Texas between 2010 and 2012. The Texas Tribune went deep on the phenomenon in January. Just this week, a new study from some of the state’s health experts found those rates were a product of faulty data, however, and dropped them significantly.

But Deviney said Tuesday that she’s confident the disparities across racial and ethnic lines still exist, even if the overall numbers have decreased.

The report from the CFT and CPPP also shows that there are significant differences when it comes to death rates among the county’s three leading causes of death. For every 100,000 black people in Dallas County, 233 die from heart disease, 194 from cancer, and 67 from stroke. Black residents are twice as likely to die from heart disease as Hispanic residents and fifty percent more likely to die from stroke, the report notes.

“It’s not just about people being more likely to have a certain kind of disease,” Deviney said. “It’s about having a disease, having insurance to take care of it, being heard, and treated similarly or differently, depending on who you are. All of these are compounding factors.”

For his part, and although he acknowledged the challenges still facing Dallas County, Jenkins made specific mention of the successes within healthcare. He said Parkland Hospital has become “maybe the best public hospital in America,” and noted that Dallas County residents signed up for marketplace insurance at some of the highest rates in the country.

“That was an opportunity that this community seized on,” Jenkins said.